SACRAMENTO, Calif. — A letter from the Center for Investigative Reporting (CIR) to the Medical Board of California revealed allegations that 148 women received unauthorized tubal ligations between 2006 and 2010. Any procedure not deemed medically necessary required authorization from the state of California, said Joyce Hayhoe, director for legislation and communication with California Correctional Health Care Services. These procedures went against California state law requiring approval prior to operation. The issue also raised significant ethical questions regarding eugenics and the standard of health care in California prisons.

The patients involved in the procedures were post-partum women from the California Institution for Women in Corona and Valley State Prison in Chowchilla, Hayhoe said. Many of these women claimed that they felt pressured or forced to sign the consent form and undergo the operation. One former inmate told the CIR, “As soon as [the physician] found out that I had five kids, he suggested that I look into getting it done…He made me feel like a bad mother if I didn’t do it.”

Other patients stated that the operation was performed directly against their wishes. One such patient, Kelli Thomas, consented to a tubal ligation only if cervical cancer was discovered on her ovaries. Although no cancer was discovered, physicians removed her ovaries anyway. Other former inmates claimed that medical staff at each prison targeted women they believed were likely to commit more crimes in the future upon their release from incarceration.

A statement from Dr. James Heinrich, a physician at Valley State Prison, sheds further light on the reasoning behind the unauthorized procedures. The State of California paid doctors who performed tubal ligations in prisons $147,460 from 1997 to 2010. “Over a 10-year period, that isn’t a huge amount of money compared to what you save in welfare paying for these unwanted children as they procreated more,” Heinrich said in explanation to the CIR.

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Justice Now, a prisoners’ rights group, has drafted a bill to officially end the practice of sterilizing inmates for reasons other than medical necessity. The bill, called the Defense Against Forced Sterilization Bill, has yet to find a sponsor in the California State Congress.

New regulations have since been implemented to prevent further unauthorized sterilizations from occurring. Hayhoe said that payment is now withheld from physicians until they have received state approval for medical procedures. Only one tubal ligation — deemed medically necessary — has been performed since 2010.